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Neuro Doctor
Neuro Doctor, Neurologist (MD)
Category: Urology
Satisfied Customers: 4756
Experience:  American Board Certified Neurologist, Internal Medicine
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UTI...waiting call from my doctor in the U.S. Looking at

Customer Question

UTI...waiting for a call from my doctor in the U.S. Looking at alternatives if he does not get back to me soon. I am a US citizen who just returned to Ghana
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: yes...I saw a doctor on Tuesday and am taking Bactrim DS. Have taken seven doses so far
JA: Anything else in your medical history you think the doctor should know?
Customer: Like I said, I am waiting for a call from the prescribing doctor.
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Urologist about your situation and then connect you two.
Submitted: 4 months ago.
Category: Urology
Expert:  DIEGO BONILLA replied 4 months ago.

Hello

This is Dr. Bonilla, experienced in Internal Medicine, Pulmonary and Critical Care.

I understand your concerns. What is your question?

Customer: replied 4 months ago.
I am taking Bactrim 800/160 for a UTI. I started the medication at 1 a.m. Mountain Time on Tuesday. So far I have taken 7 doses of the BID for 10 day course.Symptoms started on Saturday night with intense chills and fever that lasted for 6-8 hours...so maybe not related to the UTI. Have not reoccurred.Sunday: Some slight discomfort with urination throughout the day.Monday: Increasing pain with urination through the day. Around 10:30 p.m. I had blood in my urine. I started looking on the Internet to see if I needed to go to the ER. Shortly after that I had more blood in my urine. I called the doctor on call at my doctor's office and he called in the Rx and I started it at 1 a.m. TuesdayI saw the doctor on Tuesday, an already scheduled appointment for a physical, but did not discuss a plan if symptoms did not resolve and time frame for that. I left the U.S. on Tuesday night and arrived in Ghana on Wednesday night.Current symptoms are discomfort with urination and I feel like I still need to pee after I have emptied my bladder. I have some pain in my mid-back, but I think it is muscular. I did a lot of sitting that past couple of days because of travel. I am urinating frequently but I have also been drinking lots of water. I have also been taking D-Mannose which is supposed to help with UTI.I had a UTI in February or March and took Cipro 500 which was prescribed by a different doctor than I saw Tuesday. Not sure if I would take Cipro again based on all the bad press recently. I had one other UTI about 20 years ago.Not sure I am need of another antibiotic yet, but it seems like I should have fewer symptoms at this point. However, I am living in Ghana and I will be in an urban area tomorrow that would have the best selection of antibiotics. I would like to have them on hand in case things get worse
Customer: replied 4 months ago.
I am a 49 year old male in average health.
Expert:  DIEGO BONILLA replied 4 months ago.

The symptoms of persistent pain and blood in the urine is concerning for kidney stones. Another posibility is your infection been resistant to the antibiotic you are taking now. You can buy bactrim DS and take the medication twice a day for 10 days. You should go to the ER and have a CT scan to rule out kidney stones and a urine culture to determine if the bacteria is resistant to the treatment you are taking. Let me know if you have any other questions.

Customer: replied 4 months ago.
I am not sure that you carefully read my initial input. I am already taking Bactrim DS, therefore it does not make sense that you would recommend that I buy it. Also, I do not currently have pain on urination or blood in the urine, so I question your recommendation about a CT scan. Also, since I am already on an antibiotic a urine culture would not be accurate...my doctor in the U.S. told me this on Tuesday. Maybe you need to turn my information over to another doctor who is more qualified and attentive to specific detail. I need help soon!
Expert:  Neuro Doctor replied 4 months ago.

Hi, I am an American Board Certified Neurologist with experience in treating all neurological and other medical conditions and I am very glad to help you with your health concerns. The previous expert has opted out. I have experience in diagnosing and managing urinary tract conditions.

Coming to the discussion;

Your symptoms are mainly suspicious for a kidney stone, more than UTI.

Initially you had intense chills along with fever which did not recur – this pattern implies the stone most likely moved from its initial position, and possibly moved to the bladder

Since then you have been experiencing discomfort while passing urine of varying degrees and this appears due to the stone still stuck somewhere, most likely in the urinary bladder – which is what is causing persistent symptoms

The presence of blood in the urine initially correlates with the stone, rather than UTI

I guess you are not seeing blood now and this could be because the stone has moved to the bladder, also there may be microscopic bleeding which is not seen by naked eye

You seem to have recurrent UTI, so kidney stone possibility needs to be ruled out

Your recent symptoms do raise suspicion for stones (bleeding, initial chills etc)

Your symptoms are most likely from the stone rather than from UTI, this can explain why you are not improving with antibiotic Bactrim

You may try to undergo 2 important tests asap;

1) Urine analysis, even if you are on antibiotic the urine test can still tell whether you are having infection or not. Culture is still possible considering you are not responding to Bactrim. Also urine can reveal any crystals/stone particles – if stone is indeed the culprit.

2) Ultrasound of KUB (Kidney, Ureter, Bladder), OR X ray of this region too can help, but ultrasound is safer so to start with ultrasound. If ultrasound or X ray does not help then further investigations are necessary

While Quinolone antibiotics like Cipro (Ciprofloxacin) etc can cause certain serious side effects, but it sounds you did use this antibiotic before, and seem to have tolerated it well before, so it may not harm you this time too. However if you do not want to take chance with Cipro then Cephalosporin group of antibiotics or Penicillin group of antibiotics like Amoxacillin/Augmentin etc too can be considered. These antibiotics are certainly safer than Quinilone antibiotics like Cipro

UTI should not present with blood so early in the illness, that too actual blood, this is most likely a stone presenting like UTI, or stone + UTI.

Feeling like still need to pee again & again even after emptying the bladder on the back ground of prior passing blood in the urine and symptoms not responding to a good antibiotic like Bactrim all point towards a stone more than UTI. You may have secondary UTI too, but the primary issue appears to be a urinary tract stone, most likely stuck in the bladder and causing persistent symptoms, so instead of only focusing on switching the antibiotic please also consider getting proper diagnosis with urine analysis, stone workup (like ultrasound, or X ray etc to start with). If antibiotic is going to be changed then a Cephalosporin group antibiotic or penicillin group antibiotic like Augmentin/Amoxacillin can be a good choice in your case.

Please let me know if you have any further questions, and if you feel you have received the answer to your question please rate me so that I can receive credit for the time and effort put by me in answering your question.

Best regards,

Customer/p>
Expert:  Neuro Doctor replied 4 months ago.

Hi, have you received my answer posted above? I hope you are not encountering any technical glitches to access this site properly. Please take your time. Please let me know if you need any further help. Best Regards!